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What Causes Plagiocephaly?

Updated: 9 hours ago

Following the evaluation, parents almost always ask next "How did this happen?" While we have addressed the stigma surrounding helmets and flat heads in a previous post, we also want to provide an explanation about specifically what causes plagiocephaly.


Plagiocephaly is basically a flat spot on a baby's head. It can be centered or on one side. When a baby has a flat spot they typically have some cranial tissue that has been pushed elsewhere which contributes to the head shape being asymmetrical or broadened (brachycephaly). Let's look further at the causes and characteristics of plagiocephaly. For a more in-depth explanation of types of head shapes, see our previous post "Does My Baby Need A Helmet?"


Plagiocephaly "Play gee oh sef aly"

Plagiocephaly typically refers to a head shape where one side is flatter than the other on the back of the head. This flattening, if severe enough, can push the same side of the front of the head forward and the opposite side of the back of the head outward (see picture below). When this occurs the ear, eyes, cheek, and other facial bones can be effected (for more information, see "What's Wrong With a Flat Head?")



So What Causes Plagiocephaly?

Plagiocephaly is directly caused by a baby spending too much time on a preferred spot. It can be difficult to try to reposition the baby off of this spot because they prefer to lay on the flattened area for a reason. Some of these reasons include:

  • The baby's head was asymmetrical at birth due to positioning in utero or assistance used during birthing process

  • The baby has reflux and turns their head (typically to the left) to protect their esophagus

  • The baby has torticollis (muscle tightening in the neck)

  • The caregiver tends to only approach baby from one side (this is common with baby's that have right sided flattening and a right handed caregiver)

  • The baby was hospitalized and had to be positioned a specific way for medical support

We often see that plagiocephaly can pop up rather quickly because once the flat spot is there, the baby absolutely prefers to lay on the flatter part which causes it to become even more flat. Then the flat spot becomes harder to get off of and so the baby continues to lay on this flatter spot until some intervention is provided. Flat spots are usually noticed around 3-4 months of age once baby becomes more active and is sitting up. At this point some flat spots can already be quite severe.



Early Prevention

Early plagiocephaly prevention includes examining baby's head early on and being aware of any asymmetries or flattening. If you see your baby spending too much time on one side look for the flat spot there. Once you are aware of any flattening try to position baby off the flat side as much as possible. Doing tummy time activities will help baby develop strong neck muscles and allow them plenty of time off of the back of their head. Not sure what you are looking for? Come in for an evaluation! We can see your baby at any age to determine if they have any asymmetries that need monitoring.


More Questions?

Do you have more questions that you want answered by our staff of experts? Head on over to our Q&A brunch. That's right, we like to think of our mom forum as a friendly trendy cafe where you can connect with others about the helmet journey.




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